The invention relates to a device for inserting a drain into a wound according to the introductory portion of claim 1. The invention also relates to a handle for a device for inserting a drain into a wound according to the introductory portion of claim 12.
Such a device and such a handle are known from international patent application WO 98/23321. Such a device and such a handle are also known from German patent application 44 16 976.
In the treatment of open wounds, in particular deep wounds caused by surgical treatment, drains are placed before the wound is closed.
For placement of the drains, the sharp frontal end of the needle, is penetrated through the patient's skin from the inside to the outside near the wound and the needle and the drain attached thereto are drawn through the skin from the inside to the outside of the skin leaving the, usually perforated, upstream end portion of the drain in the wound. Next, the drain is detached from the needle and attached in a manner known in itself to an apparatus (such as a Redon bottle) for draining off wound fluid and the like. The entry end of the drain may also be arranged in foam material in the wound to obtain drainage from the wound over a large surface. After the positioning of the drain or drains, the wound is closed and may be sealed.
The needle has a shaft with a sharp front end and a rear end adapted for connection to the drain such that the drain is reliably secured to the needle. The external cross-sectional size of the drain is not substantially larger than the external cross-sectional size of the needle for easy passage of the transition from the shaft to the drain through the skin.
Piercing the skin with the needle requires much force because of the toughness of the skin. As the needle has to have a minimal diameter, in the order of the diameter of the drain to be applied, the surface of the needle forms only a small contact area and the performing person (for instance, a surgeon) generally wears surgical gloves, which have typically become slippery from wound fluid, blood and the like, affording little grip. Therefore, when using devices for inserting a drain as described in for instance European patent application 0 623 355 and Dutch patent application 72 16 160, it is difficult to exert the required force. Moreover, the shaft of the needle is slightly curved to facilitate leading the tip of the needle under the skin to the position where the skin is to be perforated. The small and essentially circular cross-section of the needle provides little grip to control its rotational orientation about the longitudinal axis of the needle, so that the tip of the needle can easily twist away from its orientation curved towards the inside of the skin to be perforated.
To facilitate the exertion of the required force for piercing the skin and providing better control to avoid undesired rotation of the needle about the longitudinal axis of the shaft, the known devices of the initially identified type each include a handle. The handle is detachably connected to the rear end of the needle, to which also the drain is connected, and has a central channel for at least partially receiving the drain.
The needle is pierced through the skin with the handle providing a large grip surface. After the needle has penetrated the skin sufficiently far, the needle is detached from the handle and the needle is drawn through the skin until the frontal end of the drain protrudes through the skin. The handle may for instance be withdrawn from the needle and the drain in the opposite direction and then be removed from the wound. Finally, the needle and the drain may be disconnected, and the drain may be prepared for use in the conventional manner.
Since the rear end of the needle is now provided with a handle, the needle itself may be less long than needles that are used without a handle and still be sufficiently long to allow the tip of the needle to be guided under the skin from the wound to the desired perforation position. As needles for leading a drain through the skin are generally used only once, a shorter needle produces less waste, resulting in a reduction in costs. The handle may also be disposable or be reused.
In spite of the curvature of the needle, accurately guiding the tip of the needle to the perforation position and perforating the skin still requires ergonomically awkward movements of the hand of the operator of the device, which interferes with accurate control during positioning of the tip of the needle and piercing of the skin.